| NPI | 1588008965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTIS L BONNER Atto RN Ey 770-940-4975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2013-04-29 |